As a political policy nerd, I've been absolutely astounded by the recent U.S. uproar over health care. By way of background, in 2010 U.S. President Barack Obama signed into law the Patent Protection and Affordable Care Act, generally referred to as Obamacare. Obama is a Democrat and when the Act passed, Republicans lit their hair on fire.
Following the passage of the Act, a majority of U.S. states and a number of business organizations filed actions challenging the constitutionality of Obamacare. The case was heard in the U.S. Supreme Court last week and in a 5 to 4 decision the Court upheld the Act saying it fell within the right of Congress to impose a tax and provide healthcare.
The decision has only inflamed the issue and with the U.S. presidential election just five months away U.S. politicians are in full flight. Democrats and President Obama are justifiably emboldened by the Supreme Court win while Republicans are attacking Obama's healthcare legislation as the devil incarnate combined with socialism at its worst. Talk about sore losers. Following the court ruling, Republican politicians have gone off the deep end.
Listening to the Sunday morning U.S. talk shows I heard one Republican politician say. "The U.S. already has the best healthcare system in the world." Another, a female Republican, said, "The U.S. has better breast cancer survival rates than either Canada or Britain, both countries with socialized medicine."
Hearing this it's no wonder the country is in trouble. Don't forget the Republican Party is made up of those same great folks who brought on the Iraq War, a conflict based on the bogus claim of weapons of mass destruction.
What I found most astounding in all of the Obamacare debate is the absolute inability of some U.S. politicians - and indeed the country's national media - to understand the truly sad condition of medical services in their country.
Using data from U.S. sources, here are the sad facts about health care in the land of the free and the home of the brave.
First, 50 million U.S. citizens are without health insurance and unless the employment rates improve that rate will continue. Plus, Obamacare will not fully come into effect until 2014, if it survives the fall presidential election.
Second, by any measure, the standards of health care in the U.S. are not the best in the world; rather they are well below those of other industrialized countries. Looking at life expectancy rates and using the 194-member United Nations Life Expectancy list, the U.S. comes in at number 38, just behind Cuba, but ahead of Portugal. Canada is tenth on the list. Interestingly, we tie with Macau and France. However French males do not live as long Canadian men, but French women live longer than Canadian women. There's one for feminists to ponder.
If the blowhard Republican who claimed the U.S. has the best healthcare in the world doesn't trust the U.N. figures, the Central Intelligence Agency World Factbook has similar life-expectancy rankings with Canada coming in at 12th and the U.S. at 51st. The CIA list is longer and includes non-UN entities such as the Channel Islands.
Given our longer life expectancy I found the comment about superior U.S. breast-cancer survival rates surprising and contacted a physician friend of mine who looks at health outcomes. He referred me to a couple of U.S. links dealing with cancer survival data.
I found two studies. The first studied women with breast cancer in Winnipeg and compared them with similarly diagnosed women in Des Moines, Iowa. Both studies were published by the U.S. Library of Medicine. There were 2,383 cases followed in Winnipeg and 1,545 in Des Moines. Overall, the women in Winnipeg had superior survival rates and when it came to including socio-economic factors lower-income women in the Des Moines study did quite poorly compared to their counterparts in Winnipeg.
The second study - also published by the U.S. Library of Medicine - compared breast and prostate cancer survival rates in Toronto, with those in Honolulu, Hawaii. Hawaii was studied as that state has employer-mandated health insurance. Again the results showed better cancer survival rates in Toronto than those reported in Honolulu, even with the advantage of mandatory Hawaiian health coverage.
Looking at life expectancy rates along with peer-reviewed publications it's clear the U.S. is operating at Third World standards when it comes to providing health care to its citizens. One can argue that for the very rich the U.S. provides excellent care and that's correct. But U.S. politicians are delusional if they think they have a superior system. The same goes for the U.S media who seem far too willing to accept those fictitious claims.
As Canadians we can't be too smug about our health care, after all we're only tenth when it comes to life expectancy, but at least we have a something to tweak.
In the U.S., poor health care is one thing, but even more distressing - and indeed deadly - is the absolutely fabricated political belief that there's no room for improvement.
